Bone Scan With Three-Phase Study and SPECT/CT Demonstrated Osteomyelitis in Congenital Osteosclerosis

三相骨骼掃描和SPECT／CT顯示先天性骨硬化症的骨髓炎

莊紫翎(Tzyy-Ling Chuang) ； 陳紹哲(Shao-Jer Chen) ； 周詩瑾(Shih-Chin Chou) ； 王昱豐(Yuh-Feng Wang)

《核子醫學暨分子影像雜誌》 33卷2期 (2020/06) Pp. 117-122

https://doi.org/10.6332/ANMMI.202006_33(2).0007

摘要

A 41-year-old male with congenital osteosclerosis (CO) received open reduction and internal fixation for a right femur fracture then complicated with wound infection. Three years previously, he received the Girdlestone procedure but had discharging sinus ever since. Wound culture showed Staphylococcus aureus and Peptostreptococcus prevotii. But infection persisted even after vancomycin and teicoplanin treatment. Bone scan with three-phase study and single photon emission tomography/computed tomography (SPECT/CT) showed CO with osteomyelitis (OM) in the right proximal femur. Magnetic resonance imaging confirmed osteomyelitis. Adding a dynamic phase can differentiate OM and early skeletal uptake in CO. SPECT/CT can also help verify OM better than conventional imaging.

關鍵字

congenital osteosclerosis ； osteomyelitis ； osteopetrosis ； SPECT/CT ； three-phase bone scan

並列摘要

一名41歲先天性骨硬化症（congenital osteosclerosis）男性，接受了右側股骨骨折的切開復位內固定術，然後併發了傷口感染。三年前，他接受了Girdlestone手術，但此後一直有滲出液自竇排出；傷口培養顯示金黃色葡萄球菌（Staphylococcus aureus）和消化鏈球菌（Peptostreptococcus prevotii），但即使以vancomycin和teicoplanin治療後，感染仍然持續存在。經過三相骨骼掃描和單光子電腦斷層／電腦斷層造影（single photon emission tomography/computed tomography, SPECT/CT），在右側股骨近端顯示天性骨硬化症伴有骨髓炎。磁振造影成像證實了骨髓炎。三相骨骼造影添加動態相可以區分骨髓炎和先天性骨硬化症的早期骨骼攝取。SPECT/CT也可以比傳統平面的影像更好地驗證骨髓炎。

並列關鍵字

先天性骨硬化症 ； 骨髓炎 ； 骨石化症 ； 單光子電腦斷層／電腦斷層造影 ； 三相骨骼掃描